Members
2012 iCare Family Care Partnership
Provider Access
- Evidence of Coverage
- Provider Manual
- Provider/Pharmacy Directory
- Annual Notice of Change (ANOC)
- Comprehensive Formulary
- LIS Premium Summary Sheet
- Summary of Benefits
iCare Family Care Partnership (HMO SNP) has formed a network of doctors, specialists, hospitals and long-term care providers. You must use plan providers except in emergent or urgent care situations. If you obtain routine care from out-of-network providers, without first contacting your Team and getting prior authorization, neither Medicare, Wisconsin Medicaid or iCare Family Care Partnership (HMO SNP) will pay for these services.
What are "network providers"?
Network providers are the doctors and other health care professionals, medical groups, hospitals, and other health care facilities and long-term care providers that have an agreement with us to accept our payment in full. We have arranged for these providers to deliver covered services to members in our plan.
Why do you need to know which providers are part of our network?
It is important to know which providers are part of our network because, with limited exceptions, while you are a member of our plan you must use network providers to get your medical care and services. The only exceptions are emergencies, urgently needed care when the network is not available (generally, out of the area), out-of-area dialysis services, and cases in which iCare Family Care Partnership (HMO SNP) authorizes use of non-network providers.
If you don’t have your copy of the Provider/Pharmacy Directory, you can request a copy from Member Services. You may ask Member Services for more information about our network providers, including their qualifications. You can also download the Provider/Pharmacy Directory from this website. Both Member Services and the website can give you the most up-to-date information about changes in our network providers.
What Happens if I Go to a Doctor Who is Not in Your Network?
If you choose to go to a doctor outside of our network without first contacting your Team and getting prior authorization, you must pay for these services yourself. Neither iCare Family Care Partnership (HMO SNP), Original Medicare, nor Wisconsin Medicaid will pay for these services.
Every year that you are a member of our plan, we will send you either a new Provider/Pharmacy Directory or an update to your Provider/Pharmacy Directory. This directory lists our network providers.
Contact Us
Questions? Call us at 1-800-777-4376 (TTY 1-800-947-3529), 7 days-a-week, 8:00 a.m. to 8:00 p.m. Our mailing and walk-in address is: Independent Care Health Plan, 1555 N. RiverCenter Dr., Suite 206, Milwaukee, WI 53212.
Last Updated: 11/03/2011
Family Care Partnership
PDF Resources
Listing of CMS approved iCare Medicare publications, Medicaid publications, third-party preventive health brochures.
- Abridged Formulary/iCare Medicare Plan 2012
- Abridged Formulary/iCare Partnership 2012
- Annual Notice of Change (ANOC)/iCare Medicare Plan 2012
- Annual Notice of Change (ANOC)/iCare Partnership 2012
- Anti-Smoking Quit Line (English)
- Anti-Smoking Quit Line (Spanish)
- Caregiver Background Check Policy
- Claim Form LTC Professional Services - Trizetto
- Claim Form LTC Residential Services - Trizetto
- CMS Appointment of Representative Form
- Comprehensive Formulary/iCare Medicare Plan 2012
- Comprehensive Formulary/iCare Partnership 2012
- Emergency Room Brochure
- Enrollment Form/iCare Medicare Plan 2012
- Evidence of Coverage/iCare Medicare Plan 2012
- Evidence of Coverage/iCare Partnership 2012
- Family Care Partnership Provider Application
- FCP Provider Reference Manual
- First Tier, Downstream and Related Entities Fraud
- Formulary Change Notice (iCare Medicare Plan)
- Formulary Change Notice (iCare Partnership)
- HCFA Claim Required Fields
- Limited English Proficiency Policy/Procedures
- LIS Premium Summary Sheet 2012
- Member Handbook/BadgerCare Plus Core Plan
- Member Handbook/iCare Medicaid SSI
- Member Recertification Reminder/BadgerCare Plus Core
- Notice of Privacy Practices
- Part D Coverage Determination Request Form
- Part D Prior Authorization Criteria/iCare Medicare Plan 2012
- Part D Prior Authorization Criteria/iCare Partnership 2012
- Part D Redetermination Request Form
- Pharmacy Listing/iCare Medicare Plan 2012
- Pharmacy Listing/iCare Partnership 2012
- Plan Comparisons/iCare Partnership 2012
- Power of Attorney brochure
- Primary & Acute Care Information Form
- Prior Authorization List 4/19/12
- Prior Authorization List 4/19/12 pdf
- Program Brochure/Hmong/iCare Medicaid SSI
- Program Brochure/iCare BadgerCare Plus
- Program Brochure/iCare Medicaid SSI
- Program Brochure/iCare Partnership
- Program Brochure/Spanish/iCare Medicaid SSI
- Program Overview (Spanish)/iCare Medicaid SSI
- Program Overview (Spanish)/iCare Partnership
- Provider Directory/iCare Medicaid SSI-BadgerCare Plus_Expansion Counties
- Provider Directory/iCare Medicaid SSI-BadgerCare Plus_Original Counties
- Provider Directory/Pharmacy Directory/iCare Medicare Plan Expansion Counties 2012
- Provider Directory/Pharmacy Directory/iCare Medicare Plan Original Counties 2012
- Provider Information Form (other than Partnership Program)
- Provider Reference Manual 2012
- Provider/Pharmacy Directory - iCare Partnership 2012
- Recertification Reminder (flyer)/BadgerCare Plus
- Self-Directed Supports Program Overview/iCare Partnership
- Step Therapy Prescription Drug Criteria/iCare Medicare Plan 2012
- Step Therapy Prescription Drug Criteria/iCare Partnership 2012
- Summary of Benefits/iCare Medicare Plan 2012
- Summary of Benefits/iCare Partnership 2012
- Transition Process
- UB Claim Required Fields
- Value to the Family
Call 1-800-777-4376 (TTY: 1-800-947-3529), from 8:00 a.m to 8:00 p.m.,
7 days-a-week, for further information about iCare.



